Ecthyma gangrenosum (EG) is a skin infection that is classically associated with Pseudomonas aeruginosa septicemia in immunocompromised patients. Other bacterial, viral, and fungal pathogens also have been implicated in EG. Both bacteremic and nonbacteremic forms of EG have been described. We describe a case of EG associated with methicillin-resistant Staphylococcus aureus (MRSA) in a 35-year-old woman with acute lymphoblastic leukemia (ALL) and review the literature.